Dispute over veterinary accreditor turns philosophical

Submitted by Libby A. Nelson on December 13, 2012 - 3:00am

WASHINGTON -- Either the United States already has too many veterinarians and is suffering from an alarming glut, or it has too few schools of veterinary medicine and a market place badly in need of competition.

Deans and professors of veterinary medicine, as well as the accrediting agency that deals with those schools, argued from each point of view at a meeting of the National Advisory Committee on Institutional Quality and Integrity on Wednesday morning.

The federal panel is in charge of recommending which accreditors should be granted recognition by the Education Department, after a review of each agency by department staff. When the American Veterinary Medical Association’s Council on Education came before the panel Wednesday, the conversation quickly turned from the technical issues in the staff report to broader questions facing veterinary education.

Ostensibly at issue was the accreditors’ choice to give its stamp of approval to the veterinary school at Western University of Health Sciences, a private osteopathic medical school in California, as well as to foreign colleges in Mexico and the Caribbean. Some veterinary educators from prestigious schools, including Cornell University and the University of Pennsylvania, argued that in accrediting those colleges, particularly Western, the accreditor had lowered its standards and was endorsing inferior educational techniques.

The underlying issues, though, were deeper: the proper role of for-profit colleges and veterinary schools unattached to research universities in training future veterinarians.

There are only 28 accredited schools[1] of veterinary medicine in the United States; most states have only one, or none at all. And increasing numbers of graduates are choosing careers in urban or suburban areas caring for pets, not in rural areas working with farm animals (or “food animals,” as they’re sometimes called). In response, many of those accredited colleges[2] are enrolling more students and offering incentives for graduates who choose to work outside the cities and suburbs.

But recent years have also seen an expansion of new veterinary programs, including nontraditional programs seeking accreditation from the American Veterinary Medical Association. Some are in the Caribbean; others are at standalone health science universities like Western, not attached to a traditional research university. According to some professors of veterinary medicine, it’s an alarming trend.

They argue that the new schools overwhelmingly prepare veterinarians who will care for pets, not farm animals, already an increasingly popular track, and that the coming glut of new vets will drive down salaries and make it difficult for graduates to repay their loans. Some are also skeptical of the science classes and teaching methods of the newcomers.

“These recent accreditations represent a shocking regression to a more primitive era,” said Robert R. Marshak, dean emeritus of the University of Pennsylvania's School of Veterinary Medicine. Marshak was the harshest critic of the accreditors’ recent decisions, singling out Western University particularly for criticism.

Western places its students at more than 500 clinical sites nationwide for the bulk of the students’ practical experience, and Marshak argued that it could not have enough oversight of those experiences to determine educational quality. He also said the new schools, by preparing students to take care of pets in cities and suburbs, don’t address critical veterinary needs -- for vets trained in food science, large-animal care and scientific research.

Many of the more established vet schools are at land-grant universities, often flagship institutions. In critiquing the newcomers at generally less well-known institutions -- either in the U.S. or abroad -- Marshak warned of a loss of professional prestige.

“We’re going to be a trade, rather than a profession,” he said.

Faculty and administrators at other veterinary schools signed onto written comments expressing similar concerns, particularly regarding the accreditation of Western. Other commenters argued that preparing more small-animal vets was immoral due to the popularity of that field, and that the accreditor should take the job market into consideration when it makes its decisions.

The debate before the accreditation panel echoed those that have occurred elsewhere about new entrants into fields such as medical education and many discussions about accreditation generally, raising questions about the quality of traditional and new players and about whether accreditation is sometimes used to protect existing institutions by closing out challengers.

The accrediting agency, in turn, argued that Western University and the recently accredited Caribbean institutions, St. George’s University and Ross University, had to work hard to gain the agency's approval. In many cases, the process took more than a decade and involved multiple reviews, said Sheila Allen, chair of the veterinary medical association’s Council on Education. Western University sued the accreditor in 2000, arguing that it was committing an antitrust violation by withholding accreditation; the accreditor began the approval process, and the suit was withdrawn.

Twenty-two of 28 of the accredited institutions signed a letter in support of continued federal recognition for the veterinary accreditor. Allen said that some of the resistance to accrediting Western and the Caribbean institutions was due to distrust of nontraditional models of veterinary education, but she said the accreditor’s standards remain high.

She said the accreditor plans to address the issues identified in the Education Department’s report -- most notably that members of the Council on Education are elected by members of the American Veterinary Medical Association as a whole. Still, she said some things would not change.

“We make no apology for producing entry-level veterinarians,” Allen said. “They are needed by society.”

Members of the federal panel agreed that many of the concerns raised -- such as the job market for new veterinarians -- were outside its purview, and voted to recommend giving the veterinary accreditor a year to come into compliance and have its federal recognition continued, a recommendation that is becoming standard for nearly all accreditors facing the committee.